Effect of Chin-down-plus-larynx-tightening maneuver on swallowing function after minimally invasive esophagectomy: A randomized controlled trail

Cancer Med. 2020 Aug;9(16):5889-5898. doi: 10.1002/cam4.3280. Epub 2020 Jul 6.

Abstract

Background: The incidence of swallowing abnormality was high after minimally invasive esophagectomy (MIE) for esophageal cancer (EC). Few reports, however, focused on interventions for dysphagia after esophagectomy.

Aim: The purpose of this research was to estimate the effect of Chin-down-plus-larynx-tightening maneuver on swallowing function for patients receiving esophagectomy.

Method: This was a 2-arm, parallel-group, single-blind randomized clinical trial, performed in patients suffered from EC from November 2018 to January 2020. Patients were randomly assigned to the intervention group (IG) or the control group (CG). The participants in CG received routine care, and the IG received Chin-down-plus-larynx-tightening maneuver during feeding. The incidence of choking cough, swallowing function, and dietary outcomes were evaluated before and after intervention for 7 days.

Results: A total of 237 EC cases were enrolled and randomized to the IG (n = 118) or CG (n = 119). There was no significant difference between the two groups in terms of demographic and clinical characteristics. Postoperative choking cough occurred in 5 of 118 cases (4.24%) in IG and 18 of 119 cases (19.4%) in CG, the differences showed statistically significant (P < .001). The analysis showed that the participants in the IG compared with the CG have more total caloric intake of 24 hours and higher K/R (the ratio of calories oral achieved to total calories required of body) significantly from D1 to D7 of intervention (P < .05).

Conclusion: The findings suggest that the Chin-down-plus-larynx-tightening maneuver can improve swallowing function recovery and oral total food intake and calories in EC patients undergoing MIE.

Keywords: Chin-down-plus-larynx-tightening maneuver; esophageal cancer; esophagectomy; swallowing function.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Airway Obstruction / epidemiology
  • Chin*
  • Cough / epidemiology
  • Deglutition / physiology*
  • Drinking / physiology
  • Energy Intake
  • Esophageal Neoplasms / physiopathology
  • Esophageal Neoplasms / surgery*
  • Esophagectomy / adverse effects
  • Esophagectomy / methods*
  • Female
  • Humans
  • Incidence
  • Larynx*
  • Male
  • Medical Illustration
  • Middle Aged
  • Minimally Invasive Surgical Procedures / adverse effects
  • Postoperative Complications / epidemiology
  • Postoperative Complications / physiopathology
  • Posture
  • Recovery of Function
  • Single-Blind Method